Decreased use of antibiotics using a neonatal sepsis screening technique

Antibiotic use was evaluated in an intensive care nursery before (1975-77, Group 1) and after 1978-80, Group 2) a "sepsis screen" was used at the bedside. All babies were evaluated prospectively, but the sepsis screen was available within an hour to influence decisions about antibiotics only in Group 2. The screen was positive if two or more of five simple tests were positive when investigation for possible sepsis was initiated. Group 1 and Group 2 had similar numbers of babies with proven sepsis and positive sepsis screens, and similar reasons for investigation, but there was a marked decrease (P less than 0.0001) in antibiotic use in Group 2. When only those babies with a negative sepsis screen were evaluated, the result was even more striking. This study demonstrates that antibiotic use can be decreased with the help of simple, rapid, and inexpensive tests.